Recreational Diving Medical Screening System

In 2020, the international Diver Medical Screen Committee (DMSC) released a new diver medical screening system and guidance to the physician. The following is an overview of that system.

Three-part system

  1. Diver Medical Participant Questionnaire is completed by the diving candidate.
  2. Diver Medical Physician’s Evaluation Form is completed by the physician evaluating the diving candidate for diving suitability when a physician’s approval to dive is necessary.
  3. Diving Medical Guidance is a peer reference for physicians seeking additional information regarding how specific conditions relate to diving.

System Goals/Purposes

  1. Reflect current medical thinking, and evidence-based screening criteria.
  2. Allow as many individuals to dive as reasonably possible.
  3. Be user-friendly for diving participants, supervising diving professionals and physicians.
  4. Identify and inform potential participants who may be at significant risk if they dive, that they need to secure medical evaluation of that risk.
  5. Assist Doctors of Medicine evaluating diving candidates as to whether or not they can appropriately take part in the anticipated activity with medical decision support and references provided, where a physician’s involvement is indicated.

Development and Endorsement

Beyond the endorsement by its developers, the DMSC, the new screening system reflects input from the Undersea and Hyperbaric Medical Society Diving Committee (James Chimiak, Co-chair, Charlotte Sadler, Co-chair, and Nicholas Bird, UHMS President), and the Divers Alert Network.

To get the Diver Medical Participant Questionnaire into the hands of the user group, the Recreational Scuba Training Council (RSTC) copyrights and distributes the Diver Medical Participant Questionnaire as an open source document to all recreational diver training organizations in its membership and to its sister councils worldwide (wrstc.com). It is the most widely-used recreational diver medical screening system.

The UHMS provides global access to the Diving Medical Guidance document via the UHMS website. The guidance document also includes references to medical journals and additional sources of related information to help medical professionals make informed decisions about a candidate’s medical suitability for recreational diving.

History

The Recreational Scuba Training Council (RSTC) diving medical screening system was first published in 1989. Since then, this tool has been the most frequently-used method of efficiently and effectively screening scuba divers and freedivers for training or diving activity participation. The Diver Medical Screen Committee commenced work on the new medical screening system in 2017. The new model was globally field tested for efficacy and finally completed in late 2019.

Maintenance

The Diver Medical Screen Committee facilitates periodic review of the Diving Medical Guidance and the Diver Medical Participant Questionnaire. Feedback on the questionnaire is evaluated, and the medical guidance document monitored to reflect current research and practice.

Suggestions for future revision consideration should be directed to [email address TBD]. Include your contact information, the specific suggestion as well as its foundational rationale. If you are a medical professional, please add your credentials or specialization.

Diver Medical Screen Committee

The Diver Medical Screen Committee (DMSC) consists of international diving medicine experts. This group brings to bear a wealth of expertise in diving medicine. Facilitators of the diver medical screening system and related documents meet on a periodic basis to review and refresh the diver questionnaire and diving medical guidance in concert with the UHMS Diving Medical Committee to ensure the system’s currency and appropriateness.

Nicholas Bird, MD, MMM, FAAFP, FUHM

Nick BirdNick comes to the Diver Medical Screening Committee with over 35 years in the recreational diving community. Raised in Southern California, Nick pursued his interest in diving from a young age. He was certified in 1984, became a PADI Open Water Instructor in 1989, and taught courses in Los Angeles County and Monterey Bay. He brings a unique depth of experience in diving and hyperbaric medicine with board certifications in family practice and undersea and hyperbaric medicine.

A NOAA Diving Medical Officer, he served in the United States Air Force as a flight surgeon and is a decorated combat veteran of Operation Iraqi Freedom. His multiple clinical and leadership roles include: Medical Director of Hyperbaric Medicine, Chief Medical Officer and CEO at Diver’s Alert Network (DAN), and Regional Medical Director of Duke Urgent Care. He is an active member and past president of the UHMS. An internationally recognized expert in the field he is regularly invited to speak at conferences on diving and hyperbaric medicine.

Oliver Firth, MB BS BSc MRCGP 

Oliver FirthOliver is a diving physician and former medical director of London Diving Chamber. He now runs Hyperdive, a diving medical company. Since 2006 he has gained considerable experience in the field of diving and hyperbaric medicine, managing nearly a thousand cases of decompression illness. He is an Approved Medical Examiner of Divers for the UK Health and Safety Executive, and a medical referee for the UK Diving Medical Committee. He holds the post of Honorary Lecturer at University College London and regularly gives talks on all aspects of diving and hyperbaric medicine to doctors, physiology students and local dive clubs. He has contributed a monograph on decompression illness and barotrauma to a new electronic reference textbook published by the British Medical Journal.

He remains a passionate diver and has participated in various expeditions and conservation projects throughout the globe. Oliver also enjoys cycling, snowboarding and running the occasional marathon.

Tony Frew, MD, FRCP

Tony FrewTony graduated as a physician in Cambridge then trained in respiratory medicine in London, Nottingham, Oxford, and Stoke-on-Trent.

Tony served for many years on the executive committee of the European Academy of Allergology and Clinical Immunology. Tony was one of the leading members of the UK allergy community. He oversaw and expanded an active clinical practice in acute general internal medicine, respiratory medicine and clinical allergy. He served on the British Society for Allergy & Clinical Immunology (BSACI) from 1993-2018. In 2016, in recognition of his outstanding contribution to UK clinical allergy, he was chosen by the BSACI membership to receive the William Frankland Award and in the following year elected by the membership to deliver the prestigious Jack Pepys Lecture at the BSACI Annual Meeting.

Tony was selected by the UK’s Health and Safety Executive to provide specialist advice on divers’ respiratory systems and related medical issues.

Tony loved travelling and classical music, particularly opera, and was fluent in French, German and Italian. He was a passionate diver and underwater photographer. Sadly, he passed away in November 2018.

Alessandro (Sandro) Marroni, MD, MSc, FUHM, FECB

Sandro MarroniSandro is the founder and President of DAN Europe, and Member of the Board of Directors of the International DAN Federation. Sandro has served on the European Committee for Hyperbaric Medicine, the European Foundation for the Education in Baromedicine, the International Congress on Hyperbaric Medicine, and the European Underwater and Baromedical Society.

Sandro received his Medical Degree and specialized in Underwater and Hyperbaric Medicine, Occupational Medicine, Anesthesiology and Intensive Care. He was 

Associate Professor of Underwater and Hyperbaric Medicine at the Underwater and Hyperbaric Medicine Post Graduate School of the University of Chieti, and at the Post Graduate School of Anesthesiology and Intensive Care of the University of Ancona, and has served as Professor of Hyperbaric Medicine and International Faculty Coordinator at the International Post-Graduate School of Baromedicine of the University of Belgrade Medical School, Yugoslavia, since 1997.

He serves as Professor of Diving Medicine at the Faculty of Marine Biology of the University of Ancona and at the post-graduate masters programmes in Diving and Hyperbaric Medicine at the Universities of Pisa, Italy, Catania, Padova, and Insubria.

An avid scuba diver in his youth, he became a CMAS certified diver in 1964 and has been an active scuba instructor since 1966. Author of over 250 scientific papers and publications, he is particularly active in underwater medicine research, with special interest in the prevention of Barotrauma and Dysbaric Illnesses in recreational diving.

Simon Mitchell, MB ChB, PhD, DipAdvDHM (ANZCA), DipOccMed, FUHM, FANZCA.

Simon MitchellSimon is a physician and scientist with specialist training in diving medicine and anaesthesiology. He is widely published with over 150 papers or book chapters. He co-authored the 5th edition of “Diving and Subaquatic Medicine” and has 2 chapters on decompression illness in the most recent edition of Bennett and Elliott. He has twice been Vice President of the Undersea and Hyperbaric Medicine Society (USA) and in 2010 received the society’s Behnke Award for contributions to the science of diving and hyperbaric medicine. In the past Simon was a naval diving medical officer and medical director of the Wesley Centre for Hyperbaric Medicine in Brisbane. He now works as a consultant anaesthetist at Auckland City Hospital, and is Professor in Anaesthesiology at the University of Auckland. He provides on-call cover for diving and hyperbaric emergencies at the North Shore Hospital Hyperbaric Unit in Auckland.

Simon assumed the role of Editor of Diving and Hyperbaric Medicine Journal in January 2019.

Simon’s diving career has included more than 6000 dives spanning sport, scientific, commercial, and military diving. He has been a lead member of teams that were the first to dive and identify 3 deep wrecks of high historical significance in Australia and New Zealand. At the time of one of these dives (2002) the 180m depth represented the deepest wreck dive ever undertaken. He was elected to Fellowship of the Explorers’ Club of New York in 2006, and was the DAN Rolex Diver of the Year in 2015. 

Neal W. Pollock, PhD

Neal PollockNeal is presently Associate Professor/Research Chair of Hyperbaric Medicine and Diving; his doctorate is in exercise and environmental physiology.

Neal is an Associate Professor in Kinesiology at Université Laval in Québec, QC and Research Chair at the Centre de médicine de plongée du Québec, Hôtel-Dieu de 

Lévis, QC. He was previously Research Director at Divers Alert Network (DAN) in Durham, North Carolina, and before that, Diving Officer for the University of British Columbia.  His academic training is in zoology, exercise physiology and environmental physiology. His research interests focus on human health and safety in extreme environments. He currently serves on the executive board of the Canadian Undersea and Hyperbaric Medical Association (CUHMA), as scientific director of Undersea Medicine Canada, and on the diving control board of the University of the Virgin Islands. He is also Editor-in-Chief of the peer-reviewed journal Wilderness & Environmental Medicine and on the editorial board of the peer-reviewed journal Diving and Hyperbaric Medicine.

Adel Mohamed Taher, Dr. med, MB, BCh

Adel Mohamed TaherAdel has been a consultant in diving and hyperbaric medicine as well as a scuba diving instructor since 1983. He was the driving force behind the multi-place, multi-lock recompression chamber in Sharm el-Sheikh, the first fully-equipped hyperbaric medical center in Egypt. From 2005 till 2010, the Sharm el-Sheikh recompression chamber was the most-used chamber in the world. Since 1993, it has treated over 1,700 divers. The center offers hands-on experience to dive medical specialists and medical students from all over the world.

Seeing the need for medical facilities to specialize in treating sport and recreational diving accidents, Adel also founded and supervised the Hyperbaric Medical Center in Dahab. He has devoted much of his time to educating dive professionals and physicians in dive accident management in remote areas.

Adel is a member of many international diving medical committees, the National Director of DAN-Egypt and a member of the European Underwater and Baromedical Society. He lectures about his work at universities and conferences, and he teaches several courses all over the world. Through Adel’s efforts, several laws in Egypt regarding diving safety and the availability and use of normobaric oxygen on diving vessels were improved.

 

DMSC Facilitators

Mark Caney 

Mark CaneyMark began diving in 1976. He has three times served as the president of the European Underwater Federation, a body representing the interests of all divers in Europe. He is also the Vice President & General Secretary of RSTC Europe and a board member of the Rebreather Training Council and World Recreational Scuba Training Council. He is chairman of the BSI scuba diving standards work group and is the UK’s designated expert for negotiating ISO and EN standards. Mark is Industry Relations & Training Executive for PADI Worldwide.

Julie Taylor Sanders

Julie Taylor SandersJulie began her diving career in 1981, earning the PADI Course Director credential in 1989. She held various Training positions at PADI Regional Headquarters in the US and Singapore, and is currently the International Training Executive at PADI Worldwide. During her 30+ year tenure at PADI, Julie has been active in diver safety through her contributions to diver training program development and implementation, as well as via her commitment to industry standards development through participation in several national and international recreational scuba diving standards bodies.